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DEVELOPING A FRAMEWORK OF NON-FATAL

OCCUPATIONAL INJURY SURVEILLANCE FOR RISK

CONTROL IN PALM OIL MILLS

RUMAIZAH BINTI RUSLAN

UNIVERSITI TUN HUSSEIN ONN MALAYSIA

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DEVELOPING A FRAMEWORK OF NON-FATAL OCCUPATIONAL INJURY SURVEILLANCE FOR RISK CONTROL IN PALM OIL MILLS

RUMAIZAH BINTI RUSLAN

A thesis submitted in

fulfilment of the requirement for the award of the Doctor of Philosophy in Engineering Technology

Faculty of Engineering Technology Universiti Tun Hussein Onn Malaysia

MAY 2018

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I hereby declare that the work in this thesis is my own work except for the quotations and summaries which have been duly acknowledged

Student : ... RUMAIZAH BINTI RUSLAN

Date : ...

Supervisor : ... ASSOC. PROF. DR. ISHAK BIN BABA

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For my late father, who will always be my foremost inspiration.

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ACKNOWLEDGEMENTS

I am using this opportunity to express my gratitude to everyone who supported me throughout the research years. I am thankful for their aspiring guidance, invaluably constructive criticism and friendly advice during the research work.

I would like to thank my supervisor, Assoc. Prof. Dr. Ishak bin Baba for his guidance and constant supervision as well as for providing necessary information regarding the research project and in completing the research.

I am sincerely grateful to my dearest husband and my understanding daughter for their sacrifices and unconditional love, for they always there through thick and thin. To my lovely mother and all family members for their support and tolerance with me throughout this years. May Allah bless all of you in this life and in the hereafter.

I would express my gratitude towards the management of participated palm oil mills that responded and cooperated for the research-purpose. They had continuously provided the information as well as other relevant support during this study.

I would also like to acknowledge Universiti Tun Hussein Onn Malaysia for the financial support through the Multidisciplinary Research Grant (MDR), Vot No. U099.

To all my friends, especially those who are in the same boat. No words can express my gratitude, thank you for the support. Last but not least, thank you Allah for the priceless lessons that I learned in hard way throughout this journey. Thank you for your mercy upon me.

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ABSTRACT

Non-fatal occupational injury (NFOI) and its risk factors have become a current global concern. The need of research towards the relationship between occupational injury and its risk factor is essential, to fulfil the purpose and setting the priority of implementing safety preventive approaches at workplace. This research intended to develop a framework of NFOI surveillance by using epidemiological data, noise exposure data and NFOI data among palm oil mills’ workers. A total of 420 respondents who assigned in operation and processing areas (OP) (n=333) and general or office workers (n=87) had voluntary participated in this research. A questionnaire session with respondents was held to obtain epidemiological data and NFOI information via validated questionnaire. Noise hazard monitoring was executed by using Sound Level Meter (SLM) for environmental noise monitoring and Personal Sound Dosimeter for personal noise monitoring. Gathered data were analysed in quantitative method by using statistical software IBM SPSS Statistic version 21 and a risk matrix table for injury risk rating evaluation. It was discovered that high noise exposure level (≥ 85 dB[A]) was significantly associated with non-fatal occupational injury among OP workers (φ=0.123, p<0.05) with OR=1.87 (95% CI, 1.080-3.235, p<0.05). Risk rating for reported NFOI was at moderate level, with minor cuts and scratches were the dominant type of injury (42.6%). Analysis of logistic regression indicated that working in shift, not wearing protective gloves, health problems such as shortness of breath and ringing in ears, and excessive noise level (≥ 85 dB[A]) were the risk factors of NFOI in palm oil mills among OP workers. A framework of non-fatal injury surveillance in palm oil mills was developed based on the findings with integration of risk management process and injury prevention principles. This framework is anticipated to help the management in decision making for preventive actions and early detection of occupational health effects among workers.

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ABSTRAK

Kecederaan pekerjaan yang tidak membawa maut dan faktor risikonya menjadi kebimbangan serantau masakini. Keperluan untuk mengkaji perhubungan di antara kecederaan pekerjaan dan faktor risikonya adalah penting, dalam memenuhi tujuan dan memberi keutamaan dalam pelaksanaan keselamatan dan langkah pencegahan di tempat kerja. Kajian ini bertujuan untuk membina rangkakerja pengawasan kecederaan pekerjaan yang tidak membawa maut dengan menggunakan data epidemiologi, data pendedahan bunyi hingar dan data kecederaan pekerjaan yang tidak membawa maut di kalangan pekerja kilang sawit. Seramai 420 responden, iaitu pekerja yang ditugaskan di kawasan operasi dan pemprosesan (OP) (n=333) dan pekerja biasa atau pejabat (n=87) telah terlibat secara sukarela dalam kajian ini. Sesi soal-selidik bersama responden telah dijalankan untuk mendapatkan data epidemiologi dan maklumat kecederaan pekerjaan yang tidak membawa maut melalui borang soal-selidik yang telah disahkan. Pengukuran hazad bunyi hingar telah dilaksanakan dengan menggunakan Sound Level Meter (SLM) bagi pemantauan bunyi hingar persekitaran

dan Personal Sound Dosimeter bagi pemantauan bunyi hingar perseorangan. Data

yang diperolehi telah dianalisis melalui kaedah kuantitatif dengan menggunakan perisian statistik IBM SPSS Statistic versi 21 dan jadual risiko matrik bagi penilaian kadar risiko kecederaan. Pendedahan yang tinggi terhadap bunyi hingar (≥ 85 dB[A]) didapati mempunyai hubungan yang signifikan dengan kecederaan pekerjaan yang tidak membawa maut di kalangan pekerja OP (φ=0.123, p<0.05) dengan OR=1.87 (95% CI, 1.080-3.235, p<0.05). Kadar risiko kecederaan di tempat kerja telah direkodkan pada tahap sederhana, dengan kecederaan ringan dan calar adalah jenis kecederaan yang paling dominan (42.6%). Analisis regresi logistik menyatakan bahawa bekerja syif, tidak memakai sarung tangan keselamatan, masalah kesihatan seperti sesak nafas dan telinga berdengung, dan tahap bunyi hingar yang berlebihan (≥ 85 dB[A]) adalah faktor risiko kepada kecederaan pekerjaan yang tidak membawa maut di kalangan pekerja OP kilang sawit. Rangkakerja pengawasan kecederaan

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pekerjaan yang tidak membawa maut di kilang sawit telah dibangunkan berpandukan hasil dapatan dengan menggabungkan proses pengurusan risiko dan prinsip-prinsip pencegahan kecederaan. Rangkakerja ini mampu membantu pihak pengurusan dalam membuat keputusan bagi tindakan pencegahan dan pengesanan awal kesan kesihatan pekerjaan di kalangan pekerja.

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TABLE OF CONTENTS TITLE i DECLARATION ii DEDICATION iii ACKNOWLEDGEMENTS iv ABSTRACT v ABSTRAK vi

TABLE OF CONTENTS viii

LIST OF TABLES xiv

LIST OF FIGURES xviii

LIST OF SYMBOLS AND ABBREVIATIONS xxi

LIST OF APPENDICES xxiv

CHAPTER 1 INTRODUCTION 1

1.1 Background of research 1

1.2 Background of problem 9

1.3 Statement of problem 14

1.4 Conceptual framework of research 14

1.5 Objectives of research 17

1.6 Hypotheses of research 18

1.7 Scope of research 18

1.8 Significance of research 19

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1.9 Term definition 21 1.10 Thesis outline 24

CHAPTER 2 LITERATURE REVIEW 26

2.1 Malaysia’s commodity agriculture of oil palm 26 2.1.1 Composition of oil palm 28 2.1.2 Uses of palm oil and products 30 2.1.3 Major activities in palm oil industry 31 2.1.4 Process flow in palm oil mills, workstation and workers’

job description 32 2.1.5 Research diversity in palm oil industry 37 2.1.6 Authority legislations in palm oil industry 40 2.2 Hazard and risk leading to occupational injuries

and illness 41 2.2.1 Hazard at the workplace 41 2.2.2 Occupational injuries in agriculture sector and

its impacts 44 2.2.3 Hazard, injury or illnesses, accident at palm oil mill 46 2.3 Workplace noise exposure as physical hazard 47 2.3.1 Sound and the level of sounds 47 2.3.2 Anatomy of the ear 48 2.3.3 The adverse health effect of excessive noise 50 2.3.4 Law and regulations related to noise exposure 53 2.3.5 Risk of workplace injury when exposed to noise hazards 55 2.4 Risk factors related to occupational injuries 56 2.4.1 Determination of risk factors or variables 59

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2.5 Risk management and public health approach 61 2.5.1 Risk management 62 2.5.2 Public health approach 65 2.6 Occupational injury surveillance 66 2.7 Theoretical framework 67 2.8 Summary 68 CHAPTER 3 METHODOLOGY 70 3.1 Research design 70 3.1.1 Sampling location 70 3.1.2 Population 71 3.1.3 Sampling frame 71 3.1.4 Sampling technique 73 3.1.5 Sample size 74 3.1.6 Sampling unit and respondent 76 3.2 Phases of data collection 76 3.2.1 Phase 1: Method development and preparation 77 3.2.2 Phase 2: Field-work 79 3.2.3 Phase 3: Data analysis 80 3.2.4 Phase 4: Validation of the framework development 80 3.3 Instrumentation and methods 80 3.3.1 Noise exposure assessment 82 3.3.2 Questionnaire 85 3.3.3 The risk assessment matrix 86 3.3.4 The development process of non-fatal occupational

injury (NFOI) surveillance framework 86

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3.3.5 Industrial meeting 87 3.4 Statistical analysis 91

3.5 Validation of the framework of NFOI surveillance 92

3.6 Summary 93 CHAPTER 4 PILOT STUDY 94 4.1 Introduction 94

4.1.1 Importance of pilot study 95

4.2 Background information of respondents 96

4.3 Hazard perception, training and PPE usage 98

4.4 Lifestyle and prevalence of health problems 100

4.5 Injury information 100

4.6 Highest ranking of workplace hazard and injury occurrences 103

4.7 Noise monitoring for environmental and personal exposure by workstations 104

4.8 Discussions 106

4.9 Summary 107

CHAPTER 5 RESULT & DISCUSSIONS 108

5.1 Introduction 108

5.1.1 Data of socio-demographic and work profile 109

5.1.2 Data of safe hazard perception and safe work behaviour 111

5.1.3 Data of health status and lifestyle 113

5.2 Evaluation of noise hazard and non-fatal occupational injury (NFOI) risk among palm oil mill workers 114

5.2.1 Noise exposure level in palm oil mills 115

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5.2.2 Noise exposure level at selected workstations 116 5.2.3 Frequency analysis 121 5.2.4 Analysis of non-fatal occupational injury (NFOI)

among palm oil mill workers 122 5.2.5 Association between noise exposure level and

NFOI incidence 124 5.3 Risk factors that influenced non-fatal occupational

injury (NFOI) among palm oil mills workers 126 5.3.1 Factors associated with NFOI among palm oil mills

workers 127 5.3.2 Factors influence NFOI in palm oil mills 128 5.4 Pattern of non-fatal occupational injuries (NFOI) in

palm oil mills 131 5.5 Assessment on risk rating of non-fatal occupational

injury (NFOI) in palm oil mills 135 5.6 Discussions 146 5.6.1 Noise exposure levels and non-fatal occupational

injury (NFOI) among palm oil mill’s workers 147 5.6.2 Risk factors influenced non-fatal occupational

injury (NFOI) among palm oil mills’ workers 150 5.6.3 Framework of non-fatal occupational injury

(NFOI) surveillance 151 5.7 Summary 152

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CHAPTER 6 FRAMEWORK OF NON-FATAL OCCUPATIONAL INJURY

(NFOI) SURVEILLANCE FOR PALM OIL MILLS 153

6.1 Development of non-fatal occupational injury surveillance’s framework in palm oil mills 153

6.2 Step 1: Establishing context 156

6.3 Step 2: Identification of hazard 156

6.3.1 Determination of hazards in palm oil mills 156

6.4 Step 3: Assessment of risk and risk factors 158

6.5 Step 4: Control of risk and preventive measures 159

6.6 Step 5: Reporting the risk and risk communication 162

6.7 Step 6: Continuous monitoring and review 164

6.8 The NFOI surveillance framework 164

6.8.1 The non-fatal occupational injury (NFOI) surveillance form 165

6.8.2 The application of NFOI surveillance form 168

6.9 Summary 171

CHAPTER 7 CONCLUSION & RECOMMENDATION 172

7.1 Conclusion 172

7.2 Recommendation 173

7.2.1 Risk control actions 174

7.2.2 Suggestion for future research 176

REFERENCES 177

APPENDICES 200

VITA 275

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LIST OF TABLES

1.1 Accidents reported and investigated by DOSH for

agriculture sector 4 1.2 Number of accidents reported by DOSH and

SOCSO 4

1.3 Oil palm cultivation areas in Malaysia from 2011

until 2015 5 1.4 The total operating mills, Fresh Fruit Bunches

(FFB) capacity, production of Crude Palm Oil (CPO) and Crude Palm Kernel Oil (CPKO) by

years since 2012 until 2015 6 1.5 Case of accidents reported in palm oil mills 8 1.6 Summary of past literature on occupational safety

and health issues in Malaysia’s palm oil plantation

and palm oil mill 12 1.7 Number of palm oil mills, its capacity and Fresh

Fruit Bunch (FFB) processed for 2013 and 2014 19 1.8 Terms and definitions used in this research 22 1.9 Categories of epidemiological data 23 2.1 Products from palm oil, its properties and uses 31 2.2 Job description according to the workstation 36 2.3 Summary of past literature on occupational safety

and health issues in Malaysia’s palm oil plantation

and palm oil mill 40 2.4 Hazard at workplace and its health effects by

referring to past literature review 43 2.5 Common sound levels in decibel units 48

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2.6 The Permissible Exposure Levels 54 2.7 Categories of risk factors and its explanation 57 2.8 Risk factors contributed to occupational injuries in

agricultural workplace from year 2007 until 2014 58 2.9 List of common techniques for risk assessment 63 2.10 Risk control category and examples of controls 65

3.1 List of participated palm oil mills in Southern

Peninsular Malaysia 73 3.2 Parameter tested, assessment tools and

instrumentation used, its method and quality control 81 3.3 The hybridized approach of risk management and

public health to injury prevention adopted in the

research 87 3.4 Statistical analysis tests according to research

objectives 91 4.1 Reliability analysis of the questionnaire 96 4.2 Socio-demographic and employment information 97 4.3 Multiple answers of worker’s perception of

workplace hazard 98 4.4 Training and Personal Protective Equipment (PPE)

usage while working 99 4.5 Health problems reported by respondents 100 4.6 Socio-demographic of injured workers and

characteristics of injuries 101 4.7 Number of injured workers based on workstations 103 4.8 Environmental noise and personal noise level based

on workstations 105 5.1 Analysis of Chi-Square test among palm oil mills

workers 111 5.2 Analysis of Mann Whitney-U test among palm oil

mills workers 111 5.3 Perceived hazards at palm oil mill 112

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5.4 Training and safety practice on PPE usage of palm

oil mills workers 113 5.5 Health problems reported by palm oil mills workers 113 5.6 Lifestyle information among palm oil mills workers 114 5.7 Noise exposure level based on AL and PEL

standard among palm oil mills workers 116 5.8 Environmental noise level, noise sources and type

of noise 118 5.9 Personal noise exposure among workers in

workstation (n=22) 120 5.10 Non-fatal occupational injury reported by workers

in palm oil mills 122 5.11 Prevalence analysis of injury incident among OP

workers 123 5.12 NFOI incidence among OP and Off. workers in

palm oil mills workers 124 5.13 Magnitude of the effect size for Cramer’s V/phi test

and T-test 124 5.14 Association of NFOI and noise exposure level

among workers 125 5.15 Odds ratio of noise exposure level to occupational

injury among workers in palm oil mills 125 5.16 Association between risk factors and noise exposure

level using Phi (φ) test among OP workers of palm

oil mill 128 5.17 Binary logistic regression model on factors

associated with workplace injuries among palm oil

mills workers 129 5.18 Socio-demographic, working profile and health

problems of injured workers in palm oil mills 132 5.19 Descriptive analysis of injury attribution 135 5.20 Risk matrix table for non-fatal occupational injury

amongst palm oil mill workers 138

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5.21 Risk assessment matrix of reported NFOI for palm

oil mills in the Southern Peninsular Malaysia 139 5.22 The risk priority, risk indicator and control actions 142 5.23 Summary of the risk rating and risk conclusion 143 5.24 The recommended risk control based on directive

approach and detective approach 146 5.25 The summary of the research’s hypotheses 152

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LIST OF FIGURES

1.1 Statistic of industrial accidents reported for year

2012 until 2015 3 1.2 The framework of palm oil industry sustainability 7 1.3 Numbers of active workers from year 2011 until

2015 9

1.4 The Bird Accident Ratio Triangle, 1969 11 1.5 Injury Triangle 15 1.6 Adaptation of the classic epidemiologic triad into

the current research of non-fatal occupational injury

among workers in palm oil mills 16 1.7 Conceptual framework of the research 17 2.1 Palm oil production by countries by the year 2016 28 2.2 Oil palm’s composition 30 2.3 Flowchart process of major activities in palm oil

industry 34 2.4 Flowchart process of fresh fruit bunches (FFBs)

with categories of basic work process in palm oil

mill 36

2.5 Anatomy of the ear 51 2.6 Types of risk control 68 2.7 Theoretical framework of the research 72 3.1 Distribution of palm oil mills by states in Peninsular

Malaysia 71 3.2 Southern Peninsular Malaysia’s map consists of

Johor, Melaka and Negeri Sembilan 72 3.3 The process flow of research data collection 77

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3.4 Phase 1 of data collection 78 3.5 Noise monitoring instrumentation 83 3.6 Sound Level Meter ISO-TECH SLM-1352N 83 3.7 Personal Sound Dosimeter-1355 84 3.8 Participated respondents equipped with noise

dosimeter 84 3.9 QUEST Technologies QC 10 Calibrator 85 3.10 The first series of industrial meeting 88 3.11 The second series of industrial meeting 89 3.12 The process flow of industrial meeting session 90 4.1 The usage of gloves (PPE) by boilerman on duty 99 4.2 Distribution of self-perceived hazards at workplace 104 5.1 Environmental noise level with PEL and AL

indication (FMA, 1967) for each workstation 117 5.2 The level of personal noise based on workstations

in palm oil mills 119 5.3 The frequency analysis of noise in engine room 122 5.4 Distribution of type of NFOI among OP workers in

palm oil mills 133 5.5 Body part effect based on self-reported NFOI

among OP workers 134 5.6 Priority of necessary actions to effectively manage

workplace hazards 137 5.7 The appropriate risk control labelled based on the

reported NFOI among palm oil mill workers 144 5.8 The common hierarchy of risk control with remarks

of risk control category 145 6.1 The framework development of NFOI surveillance

for palm oil mills 154 6.2 Steps involved in the identification of hazard 158 6.3 Hazard and risk assessment involved in the

development of framework 160 6.4 Risk prioritization based on research findings 163

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6.5 The framework of NFOI surveillance 164 6.6 The non-fatal occupational injury (NFOI)

surveillance form based on the developed

framework 166 6.7 The additional data incorporated in the developed

NFOI surveillance form 167 6.8 The HIRARC form with embedded linkage of

NFOI Surveillance form using existing data from

palm oil mill 169 6.9 The example of NFOI surveillance form based on

actual reported injuries 170

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LIST OF SYMBOLS AND ABBREVIATIONS

ILO - International Labour Organization US - United States

BLS - Bureau of Labor Statistic SOSCO - Social Security Organization DOSH - Department of Safety and Health GDP - Gross Domestic Product

EPU - Economic Planning Unit MPOC - Malaysia Palm Oil Council MPOB - Malaysia Palm Oil Board FFB - Fresh Fruit Bunches CPO - Crude Palm Oil

CPKO - Crude Palm Kernel Oil

RSPO - Roundtable for Sustainable Palm Oil DOSM - Department of Statistic Malaysia

OSHMS - Occupational Safety & Health Management System

ILO-OSH - International Labour Organization-Occupational Safety & Health

BS: OHSAS - British Standard: Occupational Health & Safety Assessment Series

NKEA - National Key Economics Areas

ETP - Economic Transformation Programme Ha - Alternative Hypothesis

MPOA - Malaysian Palm Oil Association PKO - Palm kernel oil

R&D - Research & Development FFA - Free Fatty Acids

EFB - Empty fruit bunches

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POME - Palm Oil Mill Effluent

SOP - Standard Operation Procedure

HIRARC - Hazard Identification, Risk Assessment & Risk Control WoS - Web of Science

sAA - salivary Alpha Amylase WBGT - Wet Bulb Globe Thermometer

ACGIH - American Conference of Governmental Industrial Hygienists WHO - World Health Organization

DALY - Disability Adjusted Life Year NFOI - Non-Fatal Occupational Injury FMA - Factories and Machinery Act MPOA - Malaysia Palm Oil Association RBD - Refined, Bleached and Deodorised PKE - Palm Kernel Expeller

EFB - Empty Fruit Bunch OER - Oil Extraction Rate dB - decibel

dB[A] - A-weighted decibel

EASHW - European Agency for Safety and Health at Work OSHA - Occupational Safety and Health Act

US OSHA - United States of Occupational Safety and Health Administration

CMID - Core Minimal Injury Dataset OCID - Optional Core Injury Dataset

Li - Likelihood

Oi - Outcome

HAZOP - Hazard and Operability study FMEA - Failure Modes Effects Analysis

SWOT - Strengths, Weaknesses, Opportunities and Threats PESTLE - Political, Economic, Social, Technological, Legal and

Environmental

ISO - International Organisation of Standardization OP - Operational & Processing worker

Off. - General or Office worker

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